Can You Heal Frozen Shoulder Without Surgery? A Physiotherapist’s Guide
Frozen shoulder can be frustrating. Reaching overhead, putting on a shirt or even sleeping on the affected side can become difficult.
The good news is that surgery is not the first treatment for most people.
What happens during a frozen shoulder?
Frozen shoulder, also called adhesive capsulitis, is usually associated with pain and significant restriction of shoulder movement.
A commonly used clinical description is:
FREEZING
Pain ↑
Movement ↓
↓
FROZEN
Pain may settle
Stiffness remains
↓
THAWING
Movement gradually improves
These stages are useful for explaining how symptoms may change, but recovery does not always follow a neat three-stage timeline. Research suggests that the traditional idea of everyone naturally progressing through three predictable stages and returning completely to normal is too simplistic.
Can physiotherapy help?
Yes!
Treatment may include:
Pain management
The early stage can be very painful. Treatment should focus on keeping the shoulder moving without repeatedly aggravating it.
Gentle mobility
Exercises are selected according to how irritable the shoulder is.
Examples may include:
Pendulum exercises
Assisted shoulder elevation
External rotation exercises
Gentle wall slides
Joint mobilisation
A physiotherapist may use manual techniques to improve shoulder movement and reduce pain.
Evidence supports exercise and mobilisation as useful components of rehabilitation, particularly as stiffness becomes the main limitation.
What about injections?
For some people, a corticosteroid injection may provide faster short-term improvement in pain and function, particularly during the painful stage. Evidence suggests that the benefit is mainly short term rather than a permanent solution.
This is why treatment may involve a combination of medical management and physiotherapy rather than choosing one over the other.
When is surgery considered?
Surgery is generally considered when symptoms remain significantly limiting despite appropriate conservative treatment, or when there is another shoulder problem that requires surgical management.
You do not need to “push through” severe pain to get your shoulder moving again.
The right amount of movement depends on how irritable your shoulder is.
